The appropriateness of drug use in an older nondemented and demented population
The appropriateness of drug use in an older nondemented and demented population
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DOI：
10.1046/j.1532-5415.2001.4930277.x
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发表时间：
2001-03-01
影响因子：
6.3
通讯作者：
Fastbom, J
中科院分区：
文献类型：
--
作者：
Giron, MST;Wang, HX;Fastbom, J
目的：为了评估老年非痴呆症和痴呆症人群中药物使用不当的程度，设计：基于81岁及以上老年受试者样本数据的描述性分析。资料收集自1994- 1996年进行的第二次随访。地点：瑞典斯德哥尔摩Kungsholmen项目的一项以人群为基础的研究。受试者主要为女性（78%）。13%的人居住在机构中，27.6%的人被诊断患有痴呆症。不适当药物使用的标准：用途：使用具有强效抗胆碱能特性的药物、药物重复、潜在的药物-药物和药物-疾病相互作用以及不适当的药物剂量。结果：平均使用的药物数量为4.6：非痴呆患者为4.5，痴呆患者为4.8。非痴呆症患者更常使用心血管系统药物，而痴呆症患者更常使用神经系统药物。痴呆患者更常接触到药物复制和具有强效抗胆碱能特性的药物，这两种药物都涉及精神药物的使用。非痴呆受试者更常暴露于潜在的药物-疾病相互作用，主要是使用心血管药物。导致潜在相互作用的最常见药物组合是地高辛与呋塞米联合使用，在非痴呆受试者中更常见。最常见的药物-疾病相互作用是充血性心力衰竭受试者使用β受体阻滞剂和钙拮抗剂。药物的剂量由两个nondemed和痴呆症的主题大多低于定义的每日dose.CONCLUSION：有大量的暴露在这个非常老的nondemed和痴呆症的人群中的药物使用的推定不适当。痴呆受试者暴露于精神药物和非痴呆受试者暴露于心血管药物，反映了该人群中这些药物的高处方频率。
OBJECTIVE: To assess the extent of inappropriateness of drug use in an older nondemented and demented population.DESIGN: Descriptive analysis based on data from a sample of older subjects age 81 years and older. Data were collected from the second follow-up conducted in 1994-1996.SETTING: A population-based study of the Kungsholmen project in Stockholm, Sweden.PARTICIPANTS: Drug information was obtained from 681 subjects with a mean age of 86.9 years. The subjects were predominantly women (78%). Thirteen percent resided in institutions and 27.6% were diagnosed with dementia.MEASUREMENTS: Dementia diagnosis based on DSM III-R. Criteria for inappropriateness of drug use: use of drugs with potent anticholinergic properties, drug duplication, potential drug-drug and drug-disease interactions, and inappropriate drug dosage.RESULTS: The mean number of drugs used was 4.6: 4.5 drugs for nondemented and 4.8 for demented subjects. Nondemented subjects more commonly used cardiovascular-system drugs and demented subjects used nervous-system drugs. Demented subjects were more commonly exposed to drug duplication and to drugs with potent anticholinergic properties, both involving the use of psychotropic drugs. Nondemented subjects were more commonly exposed to potential drug-disease interactions, mostly with the use of cardiovascular drugs. The most common drug combination leading to a potential interaction was the use of digoxin with furosemide, occurring more frequently among nondemented subjects. The most common drug-disease interaction was the use of beta-blockers and calcium antagonists in subjects with congestive heart failure. The doses of drugs taken by both nondemented and demented subjects were mostly lower than the defined daily dose.CONCLUSION: There was substantial exposure to presumptive inappropriateness of drug use in this very old nondemented and demented population. The exposure of demented subjects to psychotropic drugs and nondemented subjects to cardiovascular drugs reflect the high frequency of prescribing these drugs in this population.